The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester, RKCSB, Leicester, United Kingdom; Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom.
The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester, RKCSB, Leicester, United Kingdom.
Surv Ophthalmol. 2021 Mar-Apr;66(2):362-377. doi: 10.1016/j.survophthal.2020.10.007. Epub 2020 Oct 29.
Albinism is a group of rare inherited disorders arising from impairment of melanin biosynthesis. The reduction of melanin synthesis leads to hypopigmentation of the skin and eyes. A wide range of ophthalmic manifestations arise from albinism, including reduction of visual acuity, nystagmus, strabismus, iris translucency, foveal hypoplasia, fundus hypopigmentation, and abnormal decussation of retinal ganglion cell axons at the optic chiasm. Currently, albinism is incurable, and treatment aims either surgically or pharmacologically to optimize vision and protect the skin; however, novel therapies that aim to directly address the molecular errors of albinism, such as l-dihydroxyphenylalanine and nitisinone, are being developed and have entered human trials though with limited success. Experimental gene-based strategies for editing the genetic errors in albinism have also met early success in animal models. The emergence of these new therapeutic modalities represents a new era in the management of albinism. We focus on the known genetic subtypes, clinical assessment, and existing and emerging therapeutic options for the nonsyndromic forms of albinism.
白化病是一组罕见的遗传性疾病,源于黑色素生物合成的损伤。黑色素合成的减少导致皮肤和眼睛的色素减退。白化病会引起广泛的眼部表现,包括视力下降、眼球震颤、斜视、虹膜透明、黄斑发育不良、眼底色素减退以及视交叉处视网膜神经节细胞轴突的异常交叉。目前白化病无法治愈,治疗方法旨在通过手术或药物治疗来优化视力和保护皮肤;然而,一些旨在直接解决白化病分子错误的新型疗法,如 L-二羟苯丙氨酸和尼替西农,正在开发中并已进入人体试验阶段,但取得的效果有限。针对白化病遗传错误的实验性基因编辑策略在动物模型中也取得了早期成功。这些新治疗模式的出现代表了白化病管理的新时代。我们专注于非综合征型白化病的已知遗传亚型、临床评估以及现有和新兴的治疗选择。